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Methicillin resistant Staphylococcus aureus strains in the greater Düsseldorf area

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Abstract

Over a period of three years the incidence of methicillin resistant Staphylococcus aureus (MRSA) isolates in 11 hospitals in the greater Düsseldorf area was observed. From a total of 7,814 S. aureus isolates, 489 (6.3%) were methicillin resistant. From 198 different patients, MRSA first isolates and 291 second isolates could be cultured. Methicillin resistance among all S. aureus isolates from 11 hospitals in the greater Düsseldorf area, ranged from 0.5 to 7.8% dependant on the size of the hospital. The highest incidence (7.8%) was found in a 1,500 bed hospital and the lowest incidence in a smaller 200 bed hospital (0.5%). With respect to the distribution among clinical departments the highest incidence of MRSA isolates was found on intensive care units and surgical wards, 25.5% and 13.0% respectively. The commonest specimen from which the MRSA isolates were cultured were respiratory secretions (17.6%) followed by central venous catheter tips (12.8%). In terms of the drug resistance pattern: all isolates were resistant to the amino- glycosides and gyrase inhibitors, whereas between 80% and 90% were sensitive to fusidic acid, chloramphenicol and pyrimethamine-sulfamethoxazole. All the strains were sensitive to the glycopeptide antibiotics, vancomycin and teicoplanin. Strain typing of 181 available first isolates (from a total of 198 first isolates) by PFGE and phage lysotyping produced identical results in more than 90% of all cases. Twenty-eight different MRSA strain types were identified by PFGE and in total 23 lysotypes could be determined. During the period of investigation an increased incidence of MRSA on an intensive care unit was observed, in which a total of 204 MRSA (42% of the total number) were isolated. The strain typing using both methods showed that on that ICU eight different MRSA types were involved in this outbreak. A hygiene plan was implemented on the unit with considerable success in reducing the incidence and spread of MRSA.

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References

  1. Emori TG, Gaynes RP. An overview of nosocomial infections, including the role of the microbiology laboratory. Clin Microbiol Rev 1993; 6: 428–442.

    Google Scholar 

  2. Martone WJ, Jarvis WR, Culver DH, Haley RW. Incidence and nature of endemic and epidemic nosocomial infections. In: Bennett JV, Brachman PS (eds), Hospital infections. Boston: Little, Brown and Co, 1992: 577–596.

    Google Scholar 

  3. Mauff G. Epidemiologie übertragbarer Krankheiten. In: Brandis H, Eggers HJ, Köhler W, Pulverer G (eds), Lehrbuch der Medizinischen Mikrobiologie. Stuttgart: Gustav Fischer Verlag 1994: 48–63.

    Google Scholar 

  4. Brumfitt W, Hamilton-Miller J. Methicillin-resistant Staphylococcus aureus. N Engl J Med 1989; 320: 1188–1196.

    Google Scholar 

  5. Eadon HJ, Pinney RJ. Methicillin resistant Staphylococcus aureus: An overview. J Clin Pharm Ther 1991; 16: 453–462.

    Google Scholar 

  6. Mulligan ME, Murray KA, Ripner BS, Standifort HC, John JF, Corvick JA, Kaufmann CA, Yu VL. Methicillin resistant Staphylococcus aureus: A consensus review of the microbiology, pathogenesis, and epidemiology with implications for prevention and management. Am J Med 1993; 94: 313–328.

    Google Scholar 

  7. Hartmann BJ, Tomasz A. Expression of Methicillin resistance in heterogenous strains of Staphylococcus aureus. Antimicrob Agents Chemother 1986; 29: 85–92.

    Google Scholar 

  8. De Lencastre H, Tomasz A. Reassessment of the number of auxiliary genes essential for expression of high level methicillin resistance in Staphylococcus aureus. Antimicrob Agents Chemother 1994; 38: 2590–2598.

    Google Scholar 

  9. DeJonge BLM, Shang YS, Gage D, Tomasz A. Peptidoglycan composition of a highly Methicillin resistant Staphylococcus aureus strain. J Biol Chem 1992; 267: 11248–11254.

    Google Scholar 

  10. DeJonge BLM, Shang YS, Gage D, Tomasz A. Peptidoglycan composition in heterogeneous Tn551 mutants of a Methicillin resistant Staphylococcus aureus strain. J Biol Chem 1992; 267: 11255–11259.

    Google Scholar 

  11. Deutsches Institut für Normung: Empfindlichkeitsprüfung von Krankheitserregern gegen Chemotherapeutika. In: DIN-Taschenbuch Medizinische Mikrobiologie und Immunologie. Berlin: Beuth, 1992: 331–406.

  12. Goering RV. Molecular epidemiology of nosocomial infection: Analysis of chromosomal restriction fragment patterns by pulsed-field gel electrophoresis. Infect Control Hosp Epidemiol 1993; 14: 595–600

    Google Scholar 

  13. Bannerman TL, Hancock GA, Tenover FC, Miller JM. Pulsed-field gel electrophoresis as a replacement for bacteriophage typing of Staphylococcus aureus. J Clin Microbiol 1995; 33: 551–555.

    Google Scholar 

  14. Schlichting C, Branger C, Fournier JM, Witte W, Boutonnier A, Wolz C, Goullet, Döring G. Typing of Staphylococcus aureus by pulsed-field gel electrophoresis, zymotyping, capsular typing, and phage typing: resolution of clonal relationships. J Clin Microbiol 1993; 31: 227–232.

    Google Scholar 

  15. Witte W, Cuny C, Braulke C, Heuck D, Klare I. Überregionale, klonale Ausbreitung von MRSA. Deutschland, Bundesgesundheitsblatt 1994; 37(1): 12–16.

    Google Scholar 

  16. Panlilio A, Culver DH, Gayns RP, Banerjee S, Henderson TS, Tolson JS, Martone WLJ. Methicillin resistant Staphylococcus aureus in US hospitals, 1975–1991. Infect Control Hosp Epidemiol 1992; 13: 582–586.

    Google Scholar 

  17. Ward TT. Comparison of in vitro adherence of methicillin-sensitive and methicillin-resistant Staphylococcus aureus to human nasal epithelial cells. J Infect Dis 1992; 166: 400–404.

    Google Scholar 

  18. Sanford MD, Widmar AF, Bale MJ, Jones RN, Wenzel RP. Efficient detection and long-term persistance of the carriage of Methicillin resistant Staphylococcus aureus. Clin Infect Dis 1994; 19: 1123–1128.

    Google Scholar 

  19. Hudson IR. The efficacy intranasal Mupirocin in the prevention of staphylococcal infections: A review of recent experience. J Hosp Infect 1994; 27: 81–98.

    Google Scholar 

  20. Layton MC, Hierholzer WJ, Patterson JE. The evolving epidemiology of Methicillin resistant Staphylococcus aureus at a university hospital. Infect Control Hosp Epidemiol 1995; 16: 12–17.

    Google Scholar 

  21. Kreiswirth B, Kornblum J, Arbeit RD, Eisner W, Maslow JN, McGeer A, Low DE, Novick RP. Evidence for a clonal origin of Methicillin resistance in Staphylococcus aureus. Science 1993; 259: 227–230.

    Google Scholar 

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Authors and Affiliations

  1. Institute für Medizinische Mikrobiologie und Virologie, Düsseldorf, Germany

    Franz-Josef Schmitz, Colin R. MacKenzie, Roland Geisel, Silvia Wagner, Ulrich Hadding & Hans-Peter Heinz

  2. Eijkman-Winkler Institute for Medical Microbiology, Utrecht University, The Netherlands

    Franz-Josef Schmitz & Jan Verhoef

  3. Institute für Hygiene, Heinrich-Heine-Universität, Düsseldorf, Germany

    Helga Idel

Authors
  1. Franz-Josef Schmitz
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  2. Colin R. MacKenzie
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  3. Roland Geisel
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  4. Silvia Wagner
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  5. Helga Idel
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  6. Jan Verhoef
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  7. Ulrich Hadding
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  8. Hans-Peter Heinz
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Schmitz, FJ., MacKenzie, C.R., Geisel, R. et al. Methicillin resistant Staphylococcus aureus strains in the greater Düsseldorf area. Eur J Epidemiol 13, 709–717 (1997). https://doi.org/10.1023/A:1007338906923

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